Rokade Ashok, Sama Anshul
Department of ENT, Royal Hampshire County Hospital, Winchester, Hampshire, UK.
Curr Opin Otolaryngol Head Neck Surg. 2012 Feb;20(1):40-4. doi: 10.1097/MOO.0b013e32834e9037.
Endoscopic approaches are used increasingly as an alternative to external approaches in removal of frontal sinus osteoma. The purpose of this article is to review and highlight the recent articles on the management of frontal sinus osteoma over the past 24 months.
The evolution in endoscopic sinus surgery has allowed rhinologists to expand its indications in managing a wide range of frontal sinus pathologies, including frontal sinus osteomas. The surgeons are attempting endoscopic removal of higher grades of osteomas from frontal sinus, previously thought to be amenable only to external approach on its own or combined with endoscopic approach. Although recent retrospective studies have reported such successful attempts, open approaches, particularly osteoplastic flap, remain an important surgical technique when endoscopic approaches are limited.
The endoscopic approach is effective in surgical management of low-grade osteomas. For higher-grade (grade III and IV) osteomas endoscopic removal is technically challenging and requires availability of advanced instrumentation, including surgical navigation systems, along with surgical expertise.Open approaches to frontal sinus, particularly osteoplastic flap approach, are still valuable as it is a simple and well tolerated method for complete removal of higher-grade osteomas.
在切除额窦骨瘤时，内镜手术正越来越多地被用作外部手术的替代方法。本文旨在回顾并重点介绍过去24个月里有关额窦骨瘤治疗的最新文献。
鼻内镜鼻窦手术的发展使鼻科医生能够扩大其在处理多种额窦病变（包括额窦骨瘤）方面的适应证。外科医生正尝试通过内镜切除额窦中更高分级的骨瘤，这些骨瘤以前被认为仅适合单独采用外部手术或联合内镜手术。尽管最近的回顾性研究报告了此类成功尝试，但当内镜手术受限的时候，开放手术，尤其是骨成形瓣手术，仍然是一项重要的手术技术。
内镜手术在低分级骨瘤的外科治疗中是有效的。对于高分级（III级和IV级）骨瘤，内镜切除在技术上具有挑战性，需要具备先进的设备，包括手术导航系统，以及手术专业知识。额窦的开放手术，尤其是骨成形瓣手术，仍然很有价值，因为它是一种简单且耐受性良好的方法，可用于完全切除高分级骨瘤。
